ASHP InterSections ASHP InterSections

June 2, 2010

Pharmacy in the Age of Social Networking

Illustrated by Matt Sweitzer ©2010 ASHP

LIKE OTHER CLINICIANS, pharmacists use online social networking to maintain friendships, expand their professional relationships, and even keep in touch with patients. But as more and more clinicians try their hand at blogging or setting up profiles on sites such as Facebook, Twitter, and LinkedIn, professional and personal lines can become blurred. Maintaining the right balance requires finesse and ultimately depends on two things: your comfort level and your judgment.

If You Post It, You Publish It
The first thing to remember about social networking is that once you post something to a site, whether a blog, a bulletin board, a profile, or a page, it is published. That means that this content is fair game for viewers to judge as they see fit. Considering that your viewers may be colleagues, potential employers, or supervisors, you should always be judicious about whom you quote, the kinds of political and religious opinions you post, the types of photos you publish, and the language you use, according to Marni Lun, Pharm.D., M.B.A, director of ASHP’s Pharmacy Student Forum.

“Assume that people are going to Google you,” she said. “What is going to pop up first? Facebook? A blog? What does that say about you?”

Most social networks like Facebook allow users to adjust their privacy settings so that only friends or certain groups of people can see their pages. Although that is a useful feature, you can’t control how other people use the service, Lun added. “Check your friends’ pages and see what’s visible. When in doubt, be a tad more cautious than you otherwise would be with what you allow them to share about you.”

Greg Leatham, M.B.A., ASHP’s director of Web Communications, agrees. “Social networking is a great way to share information, learn new things, and make contacts with like-minded peers, but make sure you understand what is personal and what is professional,” he said.
“I caution people, especially students, who are often a little more free with what they put on their site, that it doesn’t matter where you plan to work,” said Leatham. “Human Resources is going to Google you as part of their recruiting process.”

The same goes for pharmacy directors, residency directors, division chairs, and other administrators who can influence your career and chances of future employment.

Pharmacy students are especially vulnerable to being their own worst enemy when it comes to online social networking. In a study published in the November 2009 issue of the American Journal of Pharmaceutical Education, researchers found that incoming first-year pharmacy students used Facebook in much the same way they did as undergraduates.

Jeff Cain, Ed.D., M.S.

“This showed us that a lot of students aren’t aware of the issues involved in using social networks once they get to a professional school,” said Jeff Cain, Ed.D., M.S., director of education technology at the University of Kentucky College of Pharmacy in Lexington. “They’ve had Facebook for several years already and used it a certain way with their peers. They don’t realize that they’re no longer seen as a student but as a future professional.”

Cain, who has published widely on the issue and has presented at ASHP meetings about professionalism in the electronic age, believes that there is a disconnect between how Facebook was intended to be used—as a social hub—and how it may actually be used by some people—to gain insight into a person’s character, judgment, and professionalism.

Cain suggests that pharmacists ask themselves one question before posting anything online: Is it something you would want pharmacy faculty, your colleagues, or your patients to see?

Friendly Patients
Most online social networks allow members to connect as friends. With 400 million users on Facebook alone, sooner or later, you are bound to receive a friend request from a patient. How should you handle it?

“There’s an entire range of possible responses,” said Bill G. Felkey, M.S., professor emeritus of health care informatics at Auburn University’s Harrison School of Pharmacy in Auburn, Ala. “I have seen professionals who maintain a high level of professional distance. Others are very comfortable with including patients and look at it as a form of relationship building.”
Many professionals fall somewhere in the middle. “It’s a sticky situation,” said Cain. “It’s like a room. If patients come into that room, they’re coming into your social life. That’s a line that wasn’t crossed before.”

Many institutions are starting to enact professional policies regarding social networking and the requirements of “e-professionalism.” In the meantime, if you are not comfortable with “friending” patients, you can always deny the request. However, in the interest of diplomacy, you might wish to explain that you use your social networks for your family and close friends only. Better yet, if you have a professional site, point your patients to it.

Tools for Collaboration
Although it is wise to be cautious when using social networks, don’t be afraid to avail yourself of the opportunities they offer for collaboration. Some sites, like LinkedIn, have been designed solely for enhancing your career.

“LinkedIn is great for professional networking,” said Amy Baker, vice chair of ASHP’s Student Forum Executive Committee. “You can post your curriculum vitae and published papers there, link to your professional blogs, and integrate your Twitter tweets there.”

Cain noted that online social networks can help strengthen weak professional ties. “If you met someone at a conference,” he said, “you can reconnect when you get home and build from there. You can also find former classmates who are now colleagues.”

You can also branch out into video with a network like YouTube, Cain said. “YouTube can be very useful for education and training,” he said. “For the pharmacy classroom, you can learn or instruct someone in different techniques. It’s also valuable for public health education. For example, there are now videos that show patients how to use an asthma inhaler. YouTube is especially effective if you want to reach a broad audience.”

Baker, who is one of several contributors to the Society’s blog, ASHPConnect, added that writing about pharmacy practice in various social media benefits the entire field. “It’s great for projecting enthusiasm and advocating for pharmacy,” she said.

Regardless of which medium you use, Baker notes that if you approach it as you would approach colleagues directly, you can’t go wrong. “Put on your white coat, even if it’s only in your mind.” 

June 1, 2010

Achieving Balance in Today’s Connected World

Diane Ginsburg, M.S., FASHP

SOCIAL NETWORKING HAS BECOME such a standard part of my day that it’s hard to believe that just a decade ago, Facebook, Twitter, etc., were mere blips on the horizon. I have to admit that it’s easy to get a little compulsive about posting updates, keeping in touch with friends and colleagues, and sharing information and opinions on everything from my latest travel exploits to what’s happening in the classroom.
As a pharmacy educator, I am blessed to be surrounded by many soon-to-be practitioners. It’s fun to tap into their wealth of knowledge about this digital world and to see how creating a virtual identity is almost second nature to this generation.

But social networking is not without its perils. As you’ll see in this issue’s cover story (page 8), we all are navigating in uncharted waters. In this new world, we’re collectively trying to figure out how best to maintain our professionalism online while taking advantage of the many social benefits of this technology. I hope the tips and tools you’ll find in the story help you to chart your course online.
You may not be aware that a lion of our profession retired recently. Rear Admiral Robert Pittman, B.S.Pharm., M.P.H., U.S. Navy, recently spoke with InterSections about his service (page 14) with the U.S. Public Health Service Commissioned Corps and the Indian Health Service. RADM Pittman’s work to bring health care to rural patients and positively influence the federal pharmacy practice model is an inspiring story for us all.
I’m sure you’ve followed the aftermath of recent catastrophic events, such as the earthquakes in Haiti and Chile. The untold story is one that’s happening at the frontlines among patient-care providers. Pharmacists who are part of Disaster Medical Assistance Teams (DMATs) and International Medical Surgical Response Teams are stepping in and providing valuable patient care. Interested in learning more about DMATs? Check out the story on page 12.

Finally, as pharmacists move into more direct patient-care roles, they are finding many opportunities to influence the health of their patients. Take a look at page 19 to see how pharmacists are using the Rx for Change (Ask-Advise-Refer) program to help patients stop using tobacco products. It’s amazing what a simple question can do to get the ball rolling toward achieving better health!
Hope you enjoy this issue! If you have any questions or suggestions for future stories, please send me an e-mail at or Looking forward to hearing from you!

Diane Ginsburg, M.S., FASHP

Summer Meeting Focuses on Medication Safety

THE 2010 SUMMER MEETING, June 6-9 in Tampa, will be a gold mine of best practices in medication safety. With a special focus on the role pharmacists can play in transforming medication safety leadership, the meeting will energize and enlighten attendees about what they can do within their own institutions. (more…)

Candidates for ASHP President-Elect, Board, HOD Announced

THE ASHP COMMITTEE ON NOMINATIONS recently selected Stanley S. Kent and Kathryn R. Schultz as candidates for ASHP president-elect. The nominating committee also approved the following candidates: (more…)

Uncle Sam Wants YOU for Disaster Relief

AS NEWS SPREADS OF THE DEVASTATION wrought by the earthquakes in Haiti and Chile this winter, many pharmacists wondered what they could do to help. One option was joining the National Disaster Medical System, which is part of the U.S. Federal Response Plan. Responding to a disaster or other emergency is grueling work, but pharmacists who are healthy and can pass a background check can qualify to be on a Disaster Medical Assistance Team (DMAT) or an International Medical Surgical Response Team (IMSuRT).

DMAT personnel provide care ranging from triage to preparing patients for evacuation. Although DMATs are designed primarily to provide help in their own regions, they also assist in other parts of the country as needed and may deploy to disaster sites around the world, usually in conjunction with an IMSuRT.

Can You Rough It?

Erasmo (Ray) Mitrano, M.S.

Serving on a DMAT or an IMSuRT is fulfilling, but it is no easy task, according to Shannon Manzi, Pharm.D., team leader for emergency services and combined programs at Children’s Hospital Boston. Manzi is a member of DMAT MA-1 and has deployed on seven missions, most recently to Haiti.

“You have to be very flexible,” she said, noting that you may not have a bed to sleep in or a shower for several weeks, you eat military MREs (meals ready to eat), and often work 12- to 16-hour shifts.

“You dig toilets, carry boxes, and set up tents,” Manzi said. “Whether you’re a brain surgeon, a medical technician, or a pharmacist, it’s all the same job, all in a very austere environment.” There are three IMSuRTs, each of which has a rapid-assembly hospital that includes mobile equipment and supplies. IMSuRT personnel stabilize patients, perform surgery, provide critical care, and prepare patients for evacuation.

To an untrained eye, field pharmacies may look like organized chaos, but they serve DMATs and IMSuRTs pharmacists well.

Members of DMATs and IMSuRTs are activated for two weeks at a time. During their deployments, members are considered federal employees, and their regular jobs are protected by federal law.

Creativity Part of Job Description
During deployments, pharmacists must use all of their pharmacy knowledge and problem-solving skills, according to Manzi. “Items may be in limited supply, and there may be no sterile area. You may end up rationing or using things in novel ways,” she said. For example, in Haiti, Manzi created rehydration solution with the salt and sugar packets that came with the MREs.

Shannon Manzi, Pharm.D., far left, assists a medical team during her recent deployment in Haiti.

The work is not without its risks, said Erasmo (Ray) Mitrano, M.S., associate chief of pharmacy, inpatient operations, at Massachusetts General Hospital in Boston, who deployed with IMSuRT East to Haiti.

“It’s easy to forget about yourself in that kind of situation, but if you don’t eat, drink, and get rest, then you aren’t going to be able to help others,” he said, recalling how several team members in Haiti had to be treated for dehydration.

If you are interested in joining a team, Mitrano suggests that you talk to someone who is already a member. “Get an overall understanding of what the commitment really is,” he said. “It’s an honor to serve, but getting onto a team is a long, involved process.”

Indeed, it is not something that pharmacists can just sign up for and start doing. A candidate must either be sponsored by an existing team member or have two professional letters of recommendation. This is followed by several interviews and background checks.

Shannon Manzi, Pharm.D.

Candidates accepted and assigned to a team then undergo extensive training that includes incident command courses, online courses, and hands-on instruction in assembling equipment and setting up field hospitals. All told, the entire process can take nine months.

“We do need a bigger pool of pharmacists,” Mitrano said. “If you are interested, now would be a great time to look into it—before disaster strikes.” 

Not Your Average Pharmacy Job

Left to right: James A. Jorgenson, M.S., Vernie R. Coleman Daniels, M.S., Laurel Kinosian, FSVHP

PRACTICING PHARMACY IN A HOSPITAL OR HEALTH SYSTEM is a challenging and exciting field with abundant career opportunities. But have you ever wondered what it would be like to pursue a nontraditional career path? Although most ASHP members practice in hospitals and health systems, some clinical pharmacists work in unexpected places.

“There are so many things pharmacists have the skill sets to do,” said Vernie R. Coleman Daniels, M.S., a research pharmacist employed by acontractor who does pharmaceutical research at Johnson Space Center in Houston. “I never would have imagined when I was in pharmacy school that I’d be doing what I’m doing today,” Daniels said, adding that opportunities for pharmacists exist in a broad range of alternative environments.

Out of This World
For Daniels, working with NASA is a path of discovery. “Medications and drug delivery systems work differently in a weightless environment,” she said. “The information in the literature about standard forms and doses may or may not be applicable. The setting is harsh.”

Zero gravity is the most obvious difference between earth and space, Daniels said, but temperature, humidity, radiation, vibration, and storage logistics are also variables that can influence a medication’s performance in space.

“We have to become creative when considering dosage forms and dosage delivery systems, which may not work the same way in the space environment as they do on earth,” Daniels said. “The blessing is that our patient population is healthy, requiring little or no pharmacotherapeutic intervention. However, should the need arise, our job is to ensure that safe and effective medication is available.”

Going for Gold
James A. Jorgenson, M.S., executive director of pharmacy at Clarian Health Methodist Hospital’s Department of Pharmacy, Indianapolis, also had the opportunity to work with patients who, though quite healthy, came with their own set of challenges: He provided pharmacy services on-site at the 2002 Olympics in Salt Lake City. At the time, he was employed at the University of Utah, whose campus served as the Olympic Village. Having played college ice hockey and being a fan of numerous sports, Jorgenson jumped at the opportunity.

From the get-go, Jorgenson and his team had to tap into their own resources of ingenuity. “We thought there would be data from previous Olympics, but there wasn’t,” he said. “We had to design the forms and create the list of banned substances from scratch. “We had to work with about 20 different pharmacopeias in addition to learning which drugs might get an athlete into trouble.”

They also worked with Pfizer Inc. to create a drug information center for the athletes, their families, and visitors from all over the world—a potential patient population of nearly 250,000 people. “Fortunately, the Olympic Committee provided interpreters,” Jorgenson said.

Although no one can be sure when the U.S. will host the Olympics next, there are opportunities to get involved in pharmacy for athletes, Jorgenson said. “There are banned substances in every major sports league, which creates an opportunity for education,” he said. “In fact, I don’t know of any league that has a good education program, so that’s something to explore.”

All Creatures Great and Small
Interpreters may have helped Jorgenson at the Olympics, but they wouldn’t be of much assistance to Laurel Kinosian, FSVHP. As a clinical instructor of pharmacy with the University of Wisconsin-Madison School of Veterinary Medicine and president of the Society of Veterinary Hospital Pharmacists, Kinosian works with patients that bark, yip, growl, meow, squawk, hiss, or simply look at her.

Veterinary pharmacists have many of the same clinical and administrative responsibilities as their counterparts in hospital pharmacy. Compounded medications must comply with requirements of state and provincial boards of pharmacy, federal regulations, and legislative statutes, much like those created for human patients.

However, animals present a plethora of unique challenges. For one thing, many veterinarians prescribe human medications for use in animals. Because of this cross-species use, veterinary pharmacists must be research-oriented and curious, said Kinosian.

“How do I get this drug into this animal? Is there any dosing information? Is there anything in the literature about this drug in this species?” she said. “You can’t make assumptions from one species to another, and the answers aren’t necessarily written in a book somewhere.”

To that end, veterinary pharmacists often turn to one another. “Veterinary pharmacy is a smaller world than human pharmacy,” Kinosian said. “That’s one of the best parts about it for me. We all get to know each other, and everyone helps.”

Getting Started
If you are interested in exploring all the options available for pharmacists who practice within hospitals and health systems, take a look at ASHP’s CareerPharm website or the information and resources on ASHP’s website.

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